Cost Sharing

A new brief explains the implications of the most recent legal challenge contesting the Affordable Care Act’s (ACA) requirement that most private insurance plans cover specific preventive care items and services—such as contraceptive services and supplies, and cancer screenings—at no cost to patients. In Braidwood Management v. Becerra, two Christian-owned…

It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any patient cost-sharing. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them…

The Inflation Reduction Act includes several provisions that will lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. This brief summarizes these provisions and discusses the expected effects on people, program spending, and drug prices and innovation.

As Medicare Advantage continues to grow, a gradual but significant reshaping of the Medicare program is taking place. A new KFF analysis finds that nearly half of eligible Medicare beneficiaries – 28.4 million out of 58.6 million Medicare beneficiaries overall – are now enrolled in Medicare Advantage plans. That represents…

This issue brief provides information about Medicare Advantage plans in 2022, including premiums, cost sharing, out-of-pocket limits, supplemental benefits, prior authorization, and star ratings, as well as trends over time.

The brief provides a quick explainer of the prescription drug provisions in the Inflation Reduction Act signed into law on August 16, 2022 and presents new estimates on how many Medicare beneficiaries could be helped by those provisions.

This analysis provides the latest data about Medicare Part D enrollment, premiums, and cost sharing in 2022 and trends over time, including information about stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans.

The brief provides a quick explainer of the prescription drug provisions in legislative text released by the Senate Finance Committee to be included in a forthcoming reconciliation bill and presents new estimates on how many Medicare beneficiaries could be helped by those provisions.

This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.

Most (53%) adults with health care debt say they have received a medical or dental bill they thought contained an error at some point in the past 5 years, and most say a state consumer assistance program would be helpful to them.